A new law signed by Gov. Andrew Cuomo orders New York’s drug court judges to stop acting like doctors and let addicted defendants continue their treatment medications.
Many, if not most, of New York’s 140-plus drug courts force drug-addicted defendants to stop taking doctor-prescribed medications and go “cold turkey” in jail. They tell the defendants that to qualify for the free court-ordered treatment and thereby have charges against them dismissed, they have to quit their methadone, Suboxone, Vivitrol or any other Medication Assisted Treatment (MAT) they might be on.
The same attitudes and practices exist in many other drug courts across the country. Judges routinely force defendants off their doctor-prescribed MAT medications, and insist on complete drug abstinence. They usually insist on 12-step programs as well which are not appropriate for everyone.
There’s a good reason why Cuomo decided to sign the new regs into law. In February, the White House Office of National Drug Control Policy (ONDCP) and the Substance Abuse and Mental Health Services Administration (SAMHSA) announced that federal funding for drug courts will be denied if offenders are made to stop taking MAT medications to treat opioid addiction.
The ONDCP and other public health agencies are pushing for wider acceptance of MAT, claiming that it offers the best chance at sobriety. But many others, especially drug court judges, call MAT drugs a “crutch”, arguing that defendants in their courtrooms should be made to abide by strict abstinence.
An ONDCP spokesperson told Huffington Post that treatment centers that insist on strict abstinence should also be on notice. Mario Moreno Zepeda said, “Our goal is to expand access to treatment, and to medication assisted treatment for opioid use disorders. We will continue working at the Federal level to increase access to these medications, as well as to strengthen policies and contractual language to ensure that grantees – including criminal justice and treatment programs – permit the use of all FDA-approved medications.”
Earlier this year, we reported on a similar situation in Kentucky, where for decades drug court judges have ordered defendants to quit MAT and adopt abstention. But the state’s lawmakers, threatened by the loss of federal funding, passed regulations forbidding judges from the practice.
After the ruling, a well-known, award-winning Kentucky Drug Court judge with decades of experience dealing with drug crimes and addictions has gone public with claims that the widespread use of drug-assisted treatment, particularly the drug Suboxone, is accomplishing next to nothing in terms of recovery. Judge David A. Tapp says he’s seen enough problems with Suboxone opioid addiction treatment to know it’s causing problems, not solving them.
Judge Tapp says Suboxone is an opioid and is more often than not being diverted and sold by addicts to pay for pills and heroin. He said a recent editorial in the Lexington, KY, Herald-Leader stating that Suboxone will reduce addiction and overdose deaths “is, to put it mildly, dead wrong.”
Meanwhile, Kentucky’s Kenton county has taken another tack and passed game-changing legislation. Kenton County is part of the so-called Tri-State Greater Cincinnati Metropolitan Area – a densely populated urban sprawl shared by Ohio, Kentucky and Indiana, that is a hotbed of drug abuse and crime. Police in Kenton now send non-violent opioid offenders straight to treatment rather than jail – a trend among police forces across the country where heroin has joined prescription opioids as the major drug problem in the region.
Here at Novus, our game-changing medical opioid detox protocols are also making waves. Patient after patient is winning their life back from opioid dependence and addiction. If you or someone you care about needs help with a drug problem, call us right away.
The New England Conference of the United Methodist Church, representing 600 congregations, is calling for an end to the country’s war on drugs, calling it “the single most devastating, dysfunctional social policy since slavery.”
The Methodists voted to support efforts to end the decades-old war on drugs through “means other than prohibition.” In other words, they want drugs legalized and addicts treated as patients, not criminals.
But the Methodists aren’t alone. They’re actually joining a burgeoning religious and secular movement across the country calling for alternatives to the heavy-handed law-enforcement approach, which they say affects a disproportionate number of minorities – particularly black and Latino.
For example, The Unitarian Universal Association, representing over 1,000 congregations, has come out against the so-called war on drugs. And in Illinois, a marijuana decriminalization bill is being pushed by Clergy for a New Drug Policy (CNDP), a coalition of Christian, Jewish, Muslim and Unitarian Universalist churches.
The Methodists’ resolution was voted in during a regional conference this past summer, and they’re hoping it will be adopted at the national level. The church says the war on drugs unintentionally leaves countless dead, destroys countless families, causes courts and prisons to be utterly overwhelmed, and cost taxpayers billions — all with little or nothing to show for it in terms of reducing the epidemic of addiction.
New approaches, they say, must include the legalization of some or all illicit drugs to deal effectively with substance abuse and to prevent the wrecking of whole families – most of them black or Latino – usually over the actions of a single family member.
“To people of color, the ‘war on drugs’ has arguably been the single most devastating, dysfunctional social policy since slavery,” the Methodist resolution said.
Powerful argument uses statistics
The Clergy for a New Drug Policy’s aims are clearly stated on its website:
“As voices of faith, we call for an end to the War on Drugs which the United States has waged, at home and abroad, for over 40 years. This War has failed to achieve its stated objectives; deepened divisions between rich and poor, black, white, and brown; squandered over one trillion dollars; and turned our country into a ‘prisoner’ nation.”
The group points out that more than 2.3 million people are now incarcerated in US prisons, more than any other nation on the planet including Russia, South Africa and even China, which has a population almost 4 times greater than ours. A huge percentage of American prisoners are jailed because of drug laws that punish non-violent drug crime – prisoners who many people believe would be better served through drug detox and rehab.
The group quotes theologian Richard Snyder, who says the U.S. to an alarming degree manifests as a “culture of punishment.”
The group goes on to say that the “weapons of punishment include a federal budget of over $215 billion for prisons, police and courts; mandatory minimum sentencing; seizures of property by law enforcement without due process; indiscriminate, and highly discriminatory, police sweeps as attempts to tamp down entire neighborhoods; and the privatizing of prisons. The ideology of this War is now embedded in our institutions of law enforcement and abetted by politicians who fear being labeled soft on crime.
“The War on Drugs when it was conceived in 1971 sought to conflate race and crime in the public mind for political purposes. This has worked. Even though drug use is roughly equivalent across ethnic groups, the vast proportion of those in jail are people of color. In 2006, one in every 15 black men was behind bars and one in every 34 Latino men, compared to one in 104 white men. As a result, young black men in most states are more likely to go to prison than college.”
“It’s a justice issue,” said Eric Dupee, the pastor of Crawford Memorial United Methodist Church in Winchester, Mass., who wrote the Methodists’ resolution. “Basically what I wanted to do is put forth the idea that our drug war is creating more harm, more problems than it’s solving, and I wanted people to be aware of that.”
Here at Novus, we’re not taking a stance on this issue, but we continue to play an essential part in the battle against addiction by helping individuals get their lives back through our cutting-edge medical detox protocols. Don’t hesitate to call us and get your questions answered about drug and alcohol detox. We’re here to help.
A mom and dad in Philadelphia who lost their son to a heroin overdose have gathered nearly 40,000 signatures on a petition on the popular moveon.org petition website.
Cris and Valerie Fiore’s petition calls for amendments to the Affordable Health Care Act to provide longer drug rehabilitation and treatment coverage.
Their son Anthony, a brilliant student just setting out on his college career, fell victim to OxyContin and soon afterward had moved on to the more-affordable heroin. A few months after three stints in rehab, two for the 21 days the family’s insurance provided and a third for only 11 days, Anthony died from a heroin overdose.
The family is convinced that Anthony could have had a real chance at recovery if he’d had at least the 90 days in rehab recommended by most experts across the country.
The family’s insurance at the time, Premera Blue Cross, would cover only 21 days. In a written response to a reporter for National Public Radio’s Weekend Edition, the insurance company said that its “medical policies are informed by national experts.”
We don’t know what experts Blue Cross was talking to, and we’ve never heard such nonsense. Of course, everyone progresses through treatment at their own rate, and there is no official predetermined length of treatment.
But according to the most authoritative body in the country, the National Institute on Drug Abuse at the National Institutes of Health, U.S. Department of Health and Human Services, and we quote:
“Research shows unequivocally that good outcomes are contingent on adequate treatment length. Generally, for residential or outpatient treatment, participation for less than 90 days is of limited effectiveness in maintaining positive outcomes.”
We added the italics to make the point – less than 90 days is of limited effectiveness – so what does that say about the insurance company experts recommending 21 days? Nothing of value.
Insurers must treat addiction like other illnesses
Under a 2008 federal law, insurers must consider drug and alcohol addiction the same as any other medical problem as far as access to treatment goes. The Department of Labor says it has investigated at least 140 claims in which such patient rights were violated. So far, all claims have been “resolved” through discussions with the insurers, the agency said. But advocates for adequate treatment say the actual information about these cases hasn’t been made public. And no fines have been issued against any insurers who violated the law.
Deb Beck, of the Drug and Alcohol Service Providers Organization of Pennsylvania, told NPR that the situation the Fiores faced is common. Treatment facilities are in a constant battle with insurers for longer coverage.
“The whole thing about who is worthy to have insurance coverage gets tangled into this,” Beck said. “But if I had a heart problem, and I didn’t do everything I was supposed to, I would not be denied coverage. In fact, if I got sicker, you would increase the coverage for me.”
Hopefully, grass roots efforts like the Fiore’s petition will bring about some changes in the insurance industry.
Meanwhile, those of us in the field of drug and alcohol treatment continue to do our best to help victims of prescription drug abuse and heroin addiction, like Anthony Fiore, complete a successful detox and get into a lengthy rehab to get their lives back.
Call Novus if you need help with a substance abuse problem. We can help answer your questions about addiction and detox, and help get you or your loved one on the road to recovery.
Categories: Drug & Alcohol Addiction Detox
Two very concerned politicians, from two of the country’s hardest-hit opioid-addiction states, are calling the FDA’s recent approval of OxyContin for kids reckless, shameful, disgusting and outrageous.
“I am disgusted by the Food and Drug Administration’s (FDA) recent decision to approve OxyContin for use for children as young as 11 years old,” Joe Manchin, the Democratic Senator from West Virginia, wrote in a letter to the FDA following the OxyContin decision. “The FDA should be absolutely ashamed of itself for this reckless act.”
And Peter Shumlin, the Democratic governor of Vermont, said the FDA is “recklessly making the problem worse with its decision to approve OxyContin for use by children as young as 11 years old.” Writing in an Op-Ed piece in the New York Times, Shumlin said, “Now is the time for the FDA to be a partner in reducing — not expanding — the availability of these drugs. Instead, it is doing the exact opposite.”
Sen. Manchin’s lengthy letter to the Acting Commissioner of the FDA, Dr. Stephen Ostroff, condemned the agency’s decision, calling it a “disconnect between the FDA approval process and the realities the deadly epidemic of prescription drug abuse are having on our communities.
“We have years of evidence that shows that drug use at an early age makes a child more likely to abuse drugs later in life. We don’t sell cigarettes or alcohol to minors, we should treat prescription drugs the same and protect our children from these harmful drugs,” Sen. Manchin added.
Gov. Shumlin’s piece in the NYTimes, titled OxyContin Is Not for Kids, said it’s true “that there are a small number of very ill children who may benefit from the extended-release nature of OxyContin, which allows for longer intervals between doses, the risks of approving this medication for kids are great. We know that teenagers are at a higher risk for addiction than adults because of their immature brain development. And we know that even if prescribed with the best of intentions, expanding the availability of these drugs in general has terrible consequences. It can lead to high rates of abuse, the use of other opioids such as heroin and, too often, death.
“It’s unfortunate but not all that surprising that the FDA is ignoring the risks of making OxyContin more widely available. Along with the pharmaceutical industry, the FDA lit the match that ignited the addiction crisis in this country when it approved OxyContin in the mid-1990s. The irrational exuberance with which painkillers were handed out following that approval is disturbing,” Gov. Shumlin added.
Here at Novus, opioid-opiate withdrawal and detox is routinely praised both by patients and detox professionals. Novus medical detox protocols remarkably reduce the pain and discomfort normally expected from the detox process. Don’t hesitate to call, because we’re here to help and are the recognized experts in advanced opiate-opioid detox.
Detoxing from heroin and prescription opioids
If you’ve ever tried to detox from heroin or prescription opioids on your own “cold turkey” you know how terrible it can be.
It can actually make the common list of opioid withdrawal symptoms seem like a day at the beach. In fact, opioid withdrawal can be so much worse it’s almost indescribable.
The good news is that detoxing from opioids does NOT have to be a scary nightmare.
Keep reading, and we’ll tell you how modern medical detox protocols, using proven holistic approaches, can greatly ease the discomfort of withdrawal.
How awful can opioid detox really be?
When you Google “opioid withdrawal symptoms” you get something like this:
Opiate withdrawal symptoms include:
- low energy, irritability, yawning
- anxiety, agitation, insomnia
- runny nose, teary eyes
- hot and cold sweats, goose bumps
- muscle aches and pains
- abdominal cramping, nausea, vomiting, diarrhea.
What’s not expressed by that list is the horrible, non-stop misery that goes on for days.
A reporter for Medical Daily recently discussed his experience getting off opioids, including heroin, and he said the endless days of no sleep was the worst.
“It feels like every horrible symptom you can think of, for any illness,” Justin Caba told another Medical Daily reporter. “The restlessness, you can’t just sleep through it, the worst is you just can’t get comfortable and sleep through it. And that’s what makes it so hard.”
Caba added that the first three days were pure hell and then it started to ease off, lasting about a week. But then the psychological symptoms begin, which took two to three months to ease up for him. “They call it post-acute withdrawal symptoms,” he said. Caba has been “clean” for over a year and a half, and is doing well.
A New York-based addiction specialist, Dr. Stuart Kloda, told Medical Daily that for some people, opioid detox can be medically serious, even life-threatening.
“Early on people will start out with yawning, watery eyes, runny nose, a bad body ache, kind of like having a really bad flu,” Dr. Kloda said. “You can also have diarrhea, nausea, and vomiting. Commonly it’s believed that withdrawal is not life-threatening, but that’s not true in all cases.”
For example, diarrhea can be so severe that is causes a life-threatening dehydration. Vomiting can be so severe it tears the esophagus and endangers one’s life. And simply the stress of withdrawal can trigger a heart attack in someone with heart disease.
How does Novus reduce the symptoms of opioid withdrawal?
At Novus Medical Detox Center, we pride ourselves in knowing how to help our patients get through opioid detox with an absolute minimum of discomfort. Most patients say they can’t believe how much easier it was than they expected.
At Novus, opioid withdrawal symptoms are greatly reduced because we employ the most up-to-date medical protocols:
- Your Metabolism
Everyone is different, so every detox program is tailored precisely to the patient. There’s no “one size fits all” at Novus.
By ensuring that patients are properly hydrated, we eliminate one of the most common dangers associated with opioid detox.
By ensuring that each patient’s nutritional needs are fully met, they are better able to deal with the stress of withdrawal.
Our medical staff utilize buprenorphine to stabilize and eliminate the discomfort of opioid cravings.
The bottom line – opioid detox that really works
Hydration, natural supplements, good food and a withdrawal protocol designed specifically for each person’s individual metabolism guarantees a more comfortable withdrawal than at other medical detox centers.
(Be warned: Some drug detox clinics saying they provide “medical detox” do little or nothing to make the detoxification process more comfortable.)
When our patients leave, they’re off all unnecessary drugs, and many leave in better health than when they arrived. And they’re in far better condition to succeed in a big way on rehab.
Don’t miss the full story about Novus opiate-opioid withdrawal and detox. We guarantee you will be impressed.
And don’t hesitate to call Novus if you or someone you love is in trouble with opioids. We’ll do everything in our power to help you find the right solution.
Yet another study (there have been many) shows that methadone replacement therapy for opioid addicts can lower HIV and hepatitis infection rates.
The latest study, published in the British medical journal The Lancet, was carried out in Vancouver, British Columbia, Canada, where methadone maintenance therapy (MMT) has been in use for decades.
By connecting methadone programs with a reduction in needle sharing(and therefore a reduction in HIV infections – facts which are already common knowledge world-wide) thestudy’s authors wanted to encourage the British Columbia government to expand its financial commitment to MMT in the province.
Between 1996 and 2013, the Canadian researchers followed 1,639 HIV-negative injection drug users. Most of the 138 people who became infected with HIV during those years were not taking methadone, the study said.
MMT requires addicts to attend a pharmacy or clinic every day and consume a small quantity of liquid methadone, itself an addictive opioid. The once-a-day dose of methadone relieves the opioid withdrawal symptoms that drive addicts to need a “fix” every few hours around the clock. Some patients, usually after years on the drug, are allowed to take a week’s worth of doses home with them.
MMT proponents defend it because people on MMT are less likely to continue to use syringes and share them with others. As the study says, “they may be less likely to engage in risky behaviors associated with spreading the virus.”
And MMT also can help some addicts “get off the street” – reduce illegal activity – andresume at least some normal activities such as a job and family life.
But…there’s a dark side
Not all addiction specialists in Vancouver – and elsewhere in the world – share such enthusiasm for MMT. In the US, only 10 percent of opioid addicts are currently treated using drugs such as methadone. The problem is that too many patients find themselves on methadone treatment for years – getting off it is worse than getting off heroin would have been.
One local treatment specialist in Vancouver compares methadone to WWII Nazi concentration camps. Jim O’Rourke, executive director of several treatment centers in the province, recently showed a reporter a picture of “hollow-eyed prisoners of Nazi concentration camps” and asked him to compare the images to the men and women standing in line at any methadone clinic.
O’Rourke says the provincial government, which pays for the methadone programs, thinks of heroin users in the same way as the “terminally ill.” When a doctor puts a patient on methadone maintenance treatment, he ignores the addict’s“problematic relationship to heroin – itcondemns them to death.”
Another local treatment specialistwho manages three homes, also refuses methadone clients. “If you’re using methadone you’re stoned,”Susan Sanderson said. “How can you possibly do a program? We tried it. We had some residents who were here on methadone. They just sat in the corner and drooled.”
A negative public view doesn’t help
Reports have appeared in the local media recently exposing kickbacks from methadone dispensing pharmacies and clinics to treatment centers if they send addicts for MMT. One pharmacy offered $100 per patient.
And the public also gets to express its own views on MMT in the media. Comments under several current and recent articles on the province’s MMT programs were unanimously negative, with not a single positive comment – and many were from current or former methadone treatment patients.
Here at Novus, we’re not politically or financially motivated towards one or another approach to treatment – we’re pragmatic and simply choose the best. Our medical opioid detox protocols are state-of-the-art, setting patients up for the best possible results from their subsequent rehab program.
And best of all, we also offer methadone patients a way out of the “methadone prison” – an innovative, safe, effective and comfortable methadone detox, regardless of the daily dose.
Don’t hesitate to call Novus if you or someone you love is trapped by opioids or methadone.
Why swimmer Michael Phelps swore off alcohol
A recent article in Swimming World describes the reasons why Olympic swimming champion Michael Phelps has sworn off alcohol – to maximize his health and strength for competition and for living a better life in general.
After two DUI arrests, a severe six-month suspension from competing in major international events and a month and a half in alcohol rehab, Phelps has made it clear to the media that he’s through with drinking at least until after the 2016 Olympics – and possibly forever.
Not just the most decorated swimmer ever, but the athlete with more Olympic gold medals than anyone in any sport, the 30-year-old super-star has his sights firmly fixed on even more gold medals in Rio next summer. The decision to stay clean and sober came after his second arrest for DUI a year ago – the first was 10 years earlier, in 2004.
“Before I even went to court, I said to myself that I’m not going to drink until after Rio – if I ever drink again,” he told Paul Newberry of the Associated Press. “That was a decision I made for myself. I’m being honest with myself. Going into 2008 and 2012, I didn’t do that. I didn’t say I was going to take a year off from drinking and not have a drink.”
“Of course,” said Eric Bugby, Associate Head Swimming and Diving Coach at West Point, writing in Swimming World magazine recently about Phelps’s decision to cut out drinking. “Why wouldn’t a professional athlete do anything and everything to be the best? Especially an athlete coming off a six-month suspension for a second DUI arrest? It’s ethical and responsible.”
But, Bugby added, refraining from drinking “is not the consensus among the athletic community, professional or amateur. Alcohol is a major part of American culture. Take a look at the NFL, MLB, NBA, NHL, WNBA, MLS, NASCAR, ATP and the PGA. Professional sports are sponsored by alcohol and promote various brands to generate revenue. They romanticize alcohol – [showing] young adults in blithe social situations.”
And the constant advertising of alcohol around sports is working, he said. Approximately 80 percent of Americans use alcohol, 80 percent of college students use alcohol and 80 percent of student-athletes use alcohol.
Alcohol is bad for athletic performance – and your health
NCAA Chief Medical Officer Brian Hainline says that everyone concerned “needs to understand the considerable negative consequences associated with excessive drinking, which pose dangers from which they need to protect themselves and others.”
Those dangers include:
- Motor skills
- Mood, and
According to the National Institute of Health, athletes should be especially concerned. Because even a single drink of alcohol compromises skeletal muscles, hydration, metabolism and the central nervous system.
“More specifically, a single drink of alcohol can decrease strength output by inhibiting calcium channels in skeletal muscles, increase evaporation and reduce body temperature, reduce glycogen uptake immediately following intensive bouts of exercise, impair balance, dexterity and REM sleep,” Coach Bugby said.
As well as detracting from performance, alcohol has a direct negative effect on recovery time – a vital element for swimmers and other high-performance athletes.
“That’s the magic word in swimming,” Coach Bugby said. “Swimmers dream of recovery. Whether it’s a full practice as part of a two-week cycle or a 30-minute nap between doubles, recovery means everything to endurance athletes and it’s the reason swimmers improve.”
Of course, the bad effects of alcohol on mood and relationships need little explanation. And within a few months of swearing off drinking, Phelps and his long-time girlfriend Nicole Johnson announced their engagement after years of a troubled off-again on-again relationship.
Phelps, who was sentenced to a year in prison, had his prison sentence suspended. But he must be on probation for a year and a half. “You don’t need a lecture from the court,” the judge told Phelps. “If you haven’t gotten the message by now, or forget the message, the only option is jail.”
It seems the message was received, loud and clear. “I recognize the seriousness of this mistake,” he said. “I’ve learned from this mistake and will continue learning from this mistake for the rest of my life.”
Phelps later he told the AP, “If I’m going to come back, I need to do this the right way. I’ve got to put my body in the best physical shape I can possibly get it in. Is it a challenge? No. I go to bed earlier. I sleep more. I wake up every day and have a completely clear head. I don’t feel like my head went through a brick wall. There are so many positives to it.
“I feel like I am okay and I am happy with who I am. I feel like I’ve learned so much about myself, who I truly am. I can honestly say there aren’t many people who have seen who I really am.”
Heroin deaths are way up in the state of Mississippi, and public health officials are more than worried.
For years there’s been one heroin-related death per year in the state. In 2012 it crept up to three, according to death certificates collected by the Health Department. Then in 2013 it doubled to six.
This year, overdose deaths have already rocketed to 13 and officials are predicting that, if the trend continues, it will reach 26 by the end of year.
Dr. Randy Easterling of Vicksburg is the medical director of the Marion Hill Chemical Dependency Unit. “A year ago, I might hardly see a heroin addict,” Easterling told a reporter from the Jackson Clarion-Ledger recently. “Now I see one every day.”
Some of the figures from the past couple or three years are hard to pin down exactly. Easterling, who is also past president of the Mississippi State Medical Association, said many overdose deaths don’t get counted because autopsies are rarely done in those cases.
But there’s no doubt that heroin is rampant in Mississippi like never before. Most states in America are undergoing the same kind of heroin invasion. Although drug overdoses are high everywhere, they’re mostly from prescription drugs. But deaths from heroin are growing faster than from any other drug.
A recent report from the Centers for Disease Control and Prevention points out that heroin is no longer “the scourge of the inner city.” Heroin is now found in the suburbs and in smaller towns and even rural communities, among people of all classes and colors. Incredible as it may seem, some of the largest jumps in heroin abuse are among white, middle-class, middle-aged women in the ‘burbs.
The CDC is calling for health care providers to pay more attention to prescription painkiller abuse and addiction. The agency says more access is needed for substance abuse treatment, like wider access to naloxone, a drug that specifically targets and interrupts an opioid overdose. Naloxone is essential and should be made widely available to help reduce overdose deaths from opioids, whether it’s heroin or prescription narcotic painkillers.
Heroin overdose deaths have at least doubled over the past decade in America, and some estimates are much higher.
Experts say there are more than one reason for this deadly increase:
- Sometimes a batch of heroin can be contaminated by a harmful or deadly toxin
- Addicts used to prescription opioids overdose on heroin because they lack experience
- And the most common reason – more people are taking heroin than ever before, mostly because it’s so much cheaper than prescription drugs:
- A single dose of heroin — about 1/10 of a gram — sells for $5 to $10, compared with $20 to $35 for an illegal oxycodone pill.
Addiction expert Dr. Scott Hambleton, medical director of the Mississippi Professionals Health Program, said that doctors’ prescribing habits have played a big role in the increase in opioid overdoses. “We have caused it,” Hambleton said. “Prescribers have caused it.”
Mississippi is the sixth highest state per capita in painkiller prescriptions, with 120 prescriptions for each 100 people.
Until the 1990s, opioid painkillers were primarily prescribed for end-of-life cancer patients. But then, in 1995, the FDA approved OxyContin, a time-release formulation of the drug oxycodone. The drug maker, Purdue Pharma, launched a campaign of misinformation to doctors claiming it should be used for all sorts of simple chronic pain, saying also that tests had shown it was less addictive than other opioids. And doctors responded by prescribing it for all sorts of aches and pains.
Purdue’s claims later proved to be false, and in the mid-2000s Purdue was fined $615 million for making illegal claims and for its illegal marketing tactics. It was a record fine at the time, but no one went to jail. And it was too late anyway – the damage already had been done. The market was flooded with OxyContin, countless thousands of individuals were addicted and dependent, and the overdose death rates soared across the country.
Easterling said that a survey showed that if a person took hydrocodone for 90 days, one in three wound up addicted. For those taking hydrocodone one time, that number was one in four.
“This is probably the most addictive medication since crack,” he said. “And it’s more available than crack.”
Hydrocodone is the active opioid ingredient in painkillers such as Vicodin, Norco, Lortab, Zohydro and Hysingla, and it is very similar to oxycodone, the active opioid ingredient in OxyContin, Percodan, Percocet and others.
Here at Novus, we’re dedicated to helping victims of opioid dependence and addiction get their lives back, free of those drugs forever. If you or someone you care for is suffering from opioid dependence, don’t hesitate to call us right away.
Maryland is likely to be the next in a growing lineup of states demanding rebates and lower prices for the opioid overdose drug naloxone, from drug maker Amphastar.
Naloxone is accepted everywhere as an absolutely vital tool in the battle to save opioid addicts from overdose. Soaring prices have put it out of reach of not just smaller communities but hundreds of city and state agencies already burdened by budget cuts.
In a letter sent to Maryland state officials, U.S. Rep. Elijah Cummings (D-Md.) said he believes the Amphastar is “overcharging” for naloxone. He warns that the price hikes could hamper efforts to fight addiction, and tells Maryland Governor Larry Hogan that he should negotiate the same kinds of rebates that New York and Ohio have already received.
And in spite of offers to provide some rebates, naloxone drug makers have come under an informal Congressional investigation.
Last January, in our blog More heroin deaths expected as naloxone prices soar, we discussed how the increase in naloxone prices was definitely impacting emergency responders in the field. Amphastar was already under fire, and we quoted Chuck Wexler, executive director of the Police Executive Research forum, who said about Amphastar’s price hikes: “It’s not an incremental increase … There’s clearly something going on.”
New York and Ohio have already won rebates from the small California drug maker. Now Vermont, New Jersey (and likely Maryland soon) are asking for rebates. And by the time you read this, other states will probably be in the lineup too.
Amphastar is the main target, although several other companies also make and sell naloxone products. Although Amphastar’s prices have more than doubled in the last year, it insists that its prices are still less than all other makers.
The main problem is that most states have been relying on Amphastar for many thousands of doses a year because of Amphastar’s convenient nasal delivery devices – the only such devices available. State and city police, emergency responders and families and friends of addicts all are recipients of the devices, which easily deliver a single dose of naloxone that immediately reverses the effects of opioid overdose.
Maryland price increases are typical
Maryland state agencies have paid as much as $41 a dose, which is a 111 percent increase from June 2014. The increases are typical, but just as in other states, not all agencies saw the same increases, and some weren’t increased at all. In Maryland, only 75 percent of agencies participating in the state’s naloxone training and distribution programs were hit with increases.
Amphastar says the different prices and price hikes were the result of pricing by different regional distributors, they weren’t set by the drug maker. The company has already begun $6-per-dose rebates for New York and Ohio, and has agreed to rebate any other states in the same amount.
According to the Pharmalot blog in the Wall Street Journal, Amphastar president Jason Shandell said that “we have not been contacted by Maryland, but we are willing to offer them and other states rebates.”
According to the Fierce Pharma blog, Ohio Attorney General Mike DeWine asked Amphastar to repay police departments and other agencies $6 a dose. He said the price of the drug had risen to $28.50 in October from a low of $12.78 in 2013. And last year, New York also negotiated a $6 per dose rebate.
But Amphastar isn’t the only company under fire for jacking up naloxone prices, Fierce Pharma said. The Clinton Foundation distributes naloxone as part of its prescription drug addiction program. And it has negotiated a discount with another naloxone provider, Kaléo Pharma.
The Foundation also approached other naloxone makers, but Kaléo was the first to respond with a discount. Fierce Pharma said the Clinton Foundation told the NY Times that it provides naloxone kits to any institution that can “widely distribute them.”
Congress now investigating naloxone price increses
In a March, 2015 letter from U.S. Rep. Elijah Cummings (D-Md) and Senator Bernie Sanders (D-Vt) to Amphastar’s CEO Jack Y. Zhang, Ph.D., the lawmakers essentially suggest that the drug maker may be cashing in on the recent shift in the perception of naloxone as a medical necessity in every city and state.
Cummings, Sanders, and three other chairmen and a ranking member, are requesting detailed financial and sales records from Amphastar “to evaluate the underlying causes of recent increases in the price of your company’s drug.”
Cummings adds that “some have suggested that these price increases coincide with an increasing number of large city police departments deciding to supply their officers with the drug. And he includes the same Chuck Wexler quote as we did in our January blog – “There’s something clearly going on.”
Meanwhile, here at Novus, it’s simply a question of getting on with things as best we know how. And our best is better than any other medical detox center we know of. If you or someone you love is in trouble with drugs or alcohol, don’t hesitate to call Novus. We are the detox and recovery experts. And we’re always here to help.
One can imagine hearing this from the designers of California’s enhanced new prescription drug database.
After $3 million spent on redevelopment, the new system may not run on countless thousands of physician’s computers which are still using older internet browsers.
The state’s prescription drug database is called the Controlled Substances Utilization Review and Evaluation System, or CURES for short. It helps track prescriptions for narcotics and other high-risk drugs, allowing physicians and pharmacists to avoid overprescribing as well as help prevent patients suffering from addiction taking advantage of multiple doctors.
The new database was designed to run on newer browsers because they offer much better security against hacking into highly-sensitive personal medical information. But it turns out that some electronic medical record systems aren’t compatible with the safer modern browsers.
The risk of non-compatibility was so high, the California Medical Association sent out a memo to warn its doctors that thousands of them could lose access to the CURES system.
Turns out the Association’s warning was true.
Hundreds of hospitals, thousands of doctors
The Los Angeles Times reports that Kaiser Permanente, which employs more than 12,000 doctors statewide and operates 35 hospitals, falls into the incompatible category.
Other affected networks include Dignity Health, which operates 39 hospitals and eight pharmacies, and Sutter Health, which has 24 hospitals and 5,000 affiliated doctors.
That’s nearly 100 hospitals and many thousands of doctors right there. And there are apparently others.
State officials say they will launch the new CURES database as planned, but will also continue to run the older version for doctors who can’t access the new one. The downside is that the high security risks remain for those still using the older version.
Prescription drug databases like CURES have been proven effective in other states in preventing doctor shopping – catching both legitimate and fake patients seeking narcotic prescriptions from multiple doctors. The systems also help identify physicians who overprescribe addictive medications.
But a Los Angeles Times investigation in 2012 found that less than 10 percent of doctors, pharmacists and other eligible providers actually signed up to use the database. The Times reports helped publicize California’s prescription drug overdose epidemic and “prompted new state efforts to combat the abuse of painkillers,” the newspaper reported recently.
A 2013 law requires health practitioners who prescribe or dispense narcotics to subscribe to the database by the end of this year. But the California Medical Association opposes efforts by some lawmakers to make use of the database mandatory. They say the system has so far not been functional enough to impose such a requirement on doctors, the Times report says.
After the most recent incompatibility mess, it sounds like the CMA is right.
California voters said “no” to CURES because of privacy concerns
Meanwhile, voters last year rejected mandatory use of the database because of concerns about privacy. Use of the database was part of a state-wide ballot on increasing limits on medical malpractice awards and drug testing of physicians. The main objection to the database was its vulnerability to hackers.
A new bill has been introduced requiring doctors to utilize the CURES system before they can prescribe certain drugs, but it’s been delayed until 2016.
Bob Pack, a California Internet executive who champions the CURES database, told the Times that “concerns about technology are overblown.” Pack contends that the medical association is blowing the browser incompatibility issue out of proportion to avoid using the system.
“I see it as a way for the CMA to continually blast the CURES program,” Pack said.
Pack’s interest in the CURES database is personal. His two children were killed by an impaired driver who had obtained multiple prescriptions for painkillers, the Times said, which could have been avoided if the database had been consulted by the doctors and pharmacists involved.
Here at Novus, we work day and night, all year round, to help patients with drug and alcohol problems get their lives back. And there’s always that idea to get it done “before it’s too late” – before something dreadful like a car accident or overdose happens.
If you or someone you care for needs help with a drug or alcohol problem, call Novus right away – before it’s too late. We’re always here to help.
Categories: Novus Medical Detox